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Brain cancer

1.
NICR/NCRI
Brain cancer…231
Chapter 21:
Brain cancer (including central nervous system; C70-C72)
(Note: Excludes benign brain tumours)
KEY FINDINGS
- INCIDENCE AND MORTALITY IN IRELAND
o There were on average 232 male and 182 females diagnosed each year during 2000-2004.
o There was no significant trend in incidence rates between 1994 and 2004 for either sex or country.
o Male incidence rates were higher than expected in Cork during 1994-2004. Among females no geographic
areas exhibited significantly higher incidence rates than expected.
o Ireland had some of the highest incidence rates of brain cancer among developed countries during 1998-
2000 with male incidence rates 15.8% higher and female incidence rates 9.3% higher than in the EU (15
countries).
o During 2000-2004 there were on average 181 male and131 female deaths per year.
o There was no significant trend in mortality rates in Ireland for either males or females or for either
country.
- SURVIVAL.AND PREVALENCE
o Relative survival from the disease was very poor with five-year (age-standardised) relative survival
estimated to be 24.4%. This value was 8.9% higher for males than females.
o There was no significant change in relative survival between those diagnosed in 1994-1996 and 1997-
1999 for either males or females or in Northern Ireland or Republic of Ireland.
o At the end of 2004 there were 1,069 people living in Ireland who had been diagnosed with the disease in
1994-2004.
- NORTH/SOUTH COMPARISONS
o Incidence rates were 15.6% lower for males and 18.2% lower for females in Northern Ireland than in
Republic of Ireland.
o There was no significant difference between Northern Ireland and Republic of Ireland in five-year (age-
standardised) relative survival for patients diagnosed in 2000-2004.
o Mortality rates were 23.6% lower in Northern Ireland than Republic of Ireland for males and 21.8%
lower for females.
o At the end of 2004 the number of people living with brain cancer per 100,000 persons, having been
diagnosed with the disease in the previous five years, was 9.6% higher in Republic of Ireland than
Northern Ireland.

8.
Cancer in Ireland 1994-2004: A comprehensive report
238…Brain cancer
than Northern Ireland with a 23.6%
difference for males and a 21.8% difference
for females (p<0.001). (Tab. 21.6)
21.3.1: Trends
Between 1994 and 2004 there was no
significant trend in European age-
standardised mortality rates (EASMR) for
brain cancer in Ireland for either males or
females. Both Northern Ireland and
Republic of Ireland considered separately
also exhibited static incidence rates
although Republic of Ireland exhibited some
evidence of a decrease in female mortality
with an annual percentage change of -2.4%
(p=0.077) although this did not reach
statistical significance. (Fig. 21.9)
Despite the static rates the number of male deaths from brain cancer rose by 2.3 per year as a result of increases in the population
and in the proportion aged over 60. The number of female deaths per year however remained fairly static over time. (Fig. 21.9)
21.4: Prevalence
At the end of 2004 there were 1,069
people living in Ireland who had been
diagnosed with brain cancer during
1994-2004, which was 25.0% of all
brain cancers diagnosed during this
period. The majority of these (676
people) were diagnosed in the 2000-
2004 period, which was 32.6% of all
those diagnosed within the five year
period. (Tab. 21.7)
The majority of those alive at the end
of 2004 having been diagnosed within the previous five years were male (352 males compared to 324 females) while 187 survivors
were resident in Northern Ireland compared to 489 in Republic of Ireland. At the end of 2004 the number of people living with brain
cancer per 100,000 persons, having been diagnosed with the disease in the previous five years, was 9.6% higher in Republic of
Ireland than Northern Ireland. (Tab. 21.7)
21.5: Discussion
The brain is part of the body that controls all other bodily functions. The most common symptoms associated with cancer of this
organ are headaches and fits, although these are common symptoms of many other ailments. Further symptoms depend upon the
location of the tumour in the brain but range from changes in personality, irritability, difficulty concentrating, memory loss and loss of
coordination or sensory problems such as loss of sense of smell.169
Figure 21.9: Trends in European age-standardised mortality rates (EASMR) for brain cancer by sex and
country: 1994-2004
0
2
4
6
8
10
12
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year of death
Europeanage-standardisedmortalityrate(EASMR)per
100,000persons
Northern Ireland
Republic of Ireland
Ireland
Male
Female
Table 21.7: Prevalence of brain cancer in Ireland at the end of 2004 by country, sex and period of diagnosis
Diagnosed 1994-2004 Diagnosed 2000-2004
Prevalence
% of cases diagnosed
during period Prevalence
% of cases diagnosed
during period
Male 142 20.7% 96 29.7%
Female 149 28.4% 91 36.7%
Northern
Ireland
All persons 291 24.1% 187 32.7%
Male 410 23.6% 256 30.6%
Female 368 27.6% 233 35.1%
Republic
of Ireland
All persons 778 25.4% 489 32.6%
Male 552 22.8% 352 30.3%
Female 517 27.8% 324 35.5%Ireland
All persons 1,069 25.0% 676 32.6%

9.
NICR/NCRI
Brain cancer…239
The only environmental factor associated with an increased risk of brain tumours is ionising radiation.170 There are however some
genetic (e.g. neurofibromatosis, tuberous sclerosis) and medical conditions (e.g. cerebral palsy in children) that increase risk by a
small amount, as does a weakened immune system.171 A small increased risk has been associated with some occupations such as
those in the petrochemical, electrical and health professions, however the evidence is inconclusive and no causal agent has been
identified.172 Despite public concern none of the following have a proven association: industrial and agricultural chemicals, viruses,
bacterial infection, head injury, diet, non-ionising radiation (power lines, mobile phones) or tobacco.173
The lack of understanding of the causes of brain cancer is a major hindrance to the development of prevention strategies for this
disease although the link with ionising radiation warrants precautions being taken with regard to the presence of ionising radiation in
the environment. These are already in place in Ireland and studies have been undertaken with regard to the possible link between
cancers linked with ionising radiation and possible radioactivity from the Irish Sea. None have demonstrated a definite link and the
high incidence of brain cancer in Ireland thus remains unexplained.
Survival from the disease remains poor as brain cancer is resistant to treatment using chemotherapy and radiotherapy. Additionally
symptoms from the disease present at a late stage which reduces survival probability among patients. However understanding of the
genetic processes in the development of the disease has improved over recent years and it is hoped that this will result in new
therapeutic approaches that will improve survival prospects.174